This is a blog that describes my thinking about autism. I hope to establish a dialogue with those interested in this subject. I believe in openness of discussion which includes different points of view.

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Sunday, January 24, 2010

Anger and Rage

"I am very angry and filled with rage. I cannot express my anger, but I feel it. This anger permeates into every part of my being. It helps me to stay alive. It gives me energy to exist. It seems to be functioning to protect me. It is like a person standing over me and protecting me. It feels as if the rage has torn me apart and allows one part of myself to take care of the parts that cannot take care of themselves. My anger and rage are being put to work to function in a way that is helping me inside. This anger and rage is inside waiting to come out. It cannot come out now because it has an important job to do, but when it does it will fill a very large room."

What is this autistic boy telling us? We can break up his message into two parts: 1) the dissociation experienced by individuals with autism and 2) how emotions such as rage and anger function within the individual with autism.

He seems to be telling us that he can feel his anger and rage, but more importantly cannot express it. From his vantage point, these emotions seem to be functioning as an internal protective mode. They protect the weaker parts of himself that cannot protect themselves. It is like they are functioning as people to protect him.

In some regards this can make sense. The individual with autism has not had a completed attachment and thus is left in a dissociated unconscious state (lowest functioning child with autism). This changes as the child develops. Thus he can become more conscious and less dissociated and then we would call him high functioning or with Asperger's. Eventually he may not be identified as being on the autism spectrum at all.

It is important to note that from the perspective of an incomplete attachment the child is functioning in a normal state of dissociation. Parts of the self are not conscious to or available to the child to use in his communications with others. It is this state that the child with autism lives. Bromberg (1994)* believes all individuals begin life made up of multiple self-states. Our wholeness develops through a relationship with another person. Because the person with autism lacks an attachment, he remains in a non-whole state. Thus the individual has different parts of himself that have not been validated, remain unconscious and are also not integrated.

In this situation, this autistic boy not only is in a normal state of dissociation, but also as he lives in this state of dissociation and as he develops, he learns to adapt to the situation and parts of himself (in this case his rage and anger) become internal methods to handle and cope with his dilemma.

I believe that as he develops a significant relationship with a person who understands his predicament, together they can forge an attachment which will help him to become less dissociated. He will be able to communicate his rage and anger and other emotions as he becomes less dissociated. As this occurs, he will be able to communicate his feelings that up to this point have only been internalized.

It is important to note that some individuals with autism are filled with rage and anger and that as they do develop we see more of the explosive anger coming out. Some individuals seem to be filled with inordinate amounts of anger. I think of this from three perspectives: 1) the excessive anger might be due to his rage at not having had a direct outlet for these emotions. In other words, he had to live without access to his emotions so he is filled with anger that has never previously seen the light of day, 2) when anger is dissociated the child does not have control over this emotion. Until the angry feelings are understood, they will come out as intermittent explosive acts of rage and 3) he probably has lots of angry feelings towards others that may not have helped him to express his anger. This may not seem logical, but I would imagine the child with autism looks to the caregivers and others to know how to solve his dilemma and when this does not occur in a reasonable period of time, his anger may grow. When he finally has access to his emotions, there is what I think of as a lot of residual anger to deal with. Thus it would be important that when working with individuals with autism from a relational perspective, to expect this build up of anger to come forward. This will be a positive move for the individual with autism, but caregivers and others may not know how to manage their own feelings when they are bombarded with these angry emotions.

* For more information on dissociation see: Bromberg, P.M. (1994) "Speak! That I May See You" Some Reflections on Dissociation, Reality, and Psychoanalytic Listening. Psychoanalytic Dialogues, 4 (4): 517-547.

3 comments:

It looks like you're talking about three important elements: dissociation, adaptation and anger/rage.

It was a therapeutic truism some years ago that: "At the core of the unattached child is RAGE".

And many intervention methods would be based on rage reduction.

Author Donna Williams created her first 'character' (his psychic structure is like the parts), Willie, when she was 2 years old.

On page 115 of Somebody Somewhere (1994 paperback edition) she says:I thought about what saves us from being consumed by ever-climbing agitation.

When someone experiences anger, it is the reassurance of closeness and security or the expression of happiness which counterbalances it so the anger doesn't consume them.

[...]How could I have a normal level of constructive anger when their misguided, well-intentioned reassurances merely stoked the fire of my defences.

And she talks about how Willie only had anger as his 'big emotion'.

Willie developed superficial emotions. It was good to be caring, so in spite of his indifference, Willie cared. It was good to be interested, so in site of his lack of curiosity, Willie was always interested. It was good to be responsible so in spite of his detachment, Willie was responsible. But the only heart-emotion Willie had was anger. This he channeled into fierce determination, his motivation an ever-clinical, ever logical sense of justice and equality.

Internal Family Systems talks about the defence mechanisms as people, and encourages writing love letters to anger.

Hi, my name is Amy and I have a younger brother who is a High-Functioning Autistic kid. He's nearly 17 now, and he goes through fits of rage all the time. I am studying to be a nurse at the moment, but I am more interested in brain development and disorders, so I've been studying things that happen during the rage outbursts in order to determine what might be the cause of them, or what might help stifle them. If any parent, sibling, relative, or even friend of a child who suffers from Autistic Rage has noticed anything particular, please let me know! The biggest lead that I have so far is that his eyes turn bloodshot when he gets in his rage, which leads me to think that his brain is not getting enough oxygen or chemicals (such as seratonin) flowing. If anyone else has noticed, I'd love to hear from you! I'm trying my best to create a medicine that will finally help those with Autistic Rage and their families. My e-mail is amy101993@gmail.com. Thank you.

My younger brother used to rage very often as a kid. He turned red, first his ears as he got excited/irritated, then his whole face at the height of his tantrums. I'm sure his heart-rate went up alot but breathing got constricted by the stress of his anxiety. He would flail around and scream yet his body seemed very stiff until it was over..all his muscles tensed. When it was over, he got totally quiet and often went to take a nap, exhausted. Often we never knew what caused his outbursts but often the reasons were very minor, the suspicion of a microbe on his sandwich or someone sneezing in the same room, things that set off his OCD fears. They usually happened in the afternoon at home, never at school.